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Gastroenterology 2022 04 17;162(4):1334-1342. Epub 2022 Feb 17.

Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan; Department of Internal Medicine and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.

Description: Proton pump inhibitors (PPIs) are among the most commonly used medications in the world. Developed for the treatment and prevention of acid-mediated upper gastrointestinal conditions, these agents are being used increasingly for indications where their benefits are less certain. PPI overprescription imposes an economic cost and contributes to polypharmacy. Read More

Surg Clin North Am 2021 Jun;101(3):381-389

To care and treat patients with esophageal cancer, one must first understand the epidemiology of Barrett's esophagus (BE). BE is defined as the intestinal metaplasia occurring within the esophagus from normal squamous epithelium to abnormal specialized columnar epithelium. BE, while first described by Allison in 1948, was attributed to Norman Barrett in 1950, who reported a case of chronic peptic ulcer in the lower esophagus that was covered by columnar epithelium. Read More

J Am Med Dir Assoc 2021 01 13;22(1):15-22. Epub 2020 Dec 13.

Department of Medicine, Geriatric Medicine, Geriatric Medicine Fellowship Program, Montefiore Medical Center, Wakefield Campus, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USA. Electronic address:

Proton pump inhibitors (PPIs) are proven medications of choice for gastroesophageal reflux disease (GERD), acid-related disorders, erosive esophagitis, Barrett esophagus, prevention of gastrointestinal bleeding while on nonsteroidal anti-inflammatory drugs, eosinophilic esophagitis, peptic ulcer disease, stress ulcer prophylaxis in critically ill patients, and other indications. Best practice guidelines from several sources on the appropriate indications and duration of PPI therapy have been summarized for easy assimilation. Individualized decision with regard to PPI use is illustrated by case vignettes; best approaches are provided. Read More

Clin Gastroenterol Hepatol 2022 03 31;20(3):692-700.e7. Epub 2020 Oct 31.

Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address:

Background & Aims: The population prevalence of gastrointestinal (GI) disease is unclear and difficult to assess in an asymptomatic population. The aim of this study was to determine prevalence of GI lesions in a largely asymptomatic population undergoing colon capsule endoscopy (CCE).

Methods: Participants aged between 50-75 years were retrieved from the Rotterdam Study, a longitudinal epidemiological study, between 2017-2019. Read More

Clin Res Hepatol Gastroenterol 2021 Jul 7;45(4):101540. Epub 2020 Oct 7.

Department of Gastroenterology and Digestive Endoscopy, George Pompidou European Hospital and University of Paris, France.

Background And Study Aims: Large scale data on esophagogastroduodenoscopy (EGD) in Western countries are scarce. We conducted a prospective study on the diagnostic yield of upper gastrointestinal endoscopy in France.

Patients And Methods: An online questionnaire was sent to all French gastroenterologists practicing endoscopy. Read More

Endoscopy 2020 06 14;52(6):491-497. Epub 2020 Apr 14.

Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal.

With the aim of reducing the overall burden of care, ESGE recommends against surveillance of a series of conditions. Namely: ESGE RECOMMENDS: against surveillance of individuals with the following: an inlet esophageal patch; Los Angeles (LA) grade A or B erosive esophagitis; or < 1 cm columnar-lined esophagus. ESGE RECOMMENDS: against surveillance of those with intestinal metaplasia limited to the antrum unless additional risk factors are present, such as persistent infection, incomplete metaplasia, or a family history of gastric cancer; or for fundic gland polyps in the absence of suspicious endoscopic features or hereditary syndromes. Read More

Aerosp Med Hum Perform 2019 Nov;90(11):986-988

Obes Surg 2019 12;29(12):3809-3817

Department of Surgery, University Hospital, University of Chile, Santos Dumont #999, Santiago, Chile.

Objective: Perform a prospective study based on sequential clinical, endoscopic, and histologic evaluations of the foregut late after laparoscopic sleeve gastrectomy (LSG) in obese patients. After LSG, several studies have suggested an increase in the incidence of clinical gastroesophageal reflux (GERD) while others have reported an improvement but based mainly on clinical questionnaires.

Methods: Prospective study of 104 consecutive patients submitted to LSG. Read More

J Am Geriatr Soc 2019 12 5;67(12):2600-2604. Epub 2019 Sep 5.

Division of Geriatrics, David Geffen School of Medicine at UCLA and Veterans Affairs (VA) Greater Los Angeles Healthcare System Geriatric Research Education and Clinical Center, Los Angeles, California.

Background: Older adults are particularly vulnerable to complications from proton pump inhibitor (PPI) drugs. We sought to characterize the prevalence of potentially low-value PPI prescriptions among older adults to inform a quality improvement (QI) intervention.

Methods: We created a cohort of patients, aged 65 years or older, receiving primary care at a large academic health system in 2018. Read More

Kaohsiung J Med Sci 2019 Jun 18;35(6):341-349. Epub 2019 Apr 18.

Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

This study examines the effects of environmental hazards, including tobacco, alcohol/alcohol flush response, areca nut, and Helicobacter pylori (H pylori) infection on upper digestive diseases. This is a multi-hospital-based endoscopy-survey cross-sectional study. Subjects were received upper endoscopies in outpatient clinics at four hospitals in Taiwan between 2008 and 2013. Read More

Endoscopy 2019 07 12;51(7):E189-E190. Epub 2019 Apr 12.

Section of Gastroenterology, VA Boston Healthcare System, Boston, Massachusetts, United States.

Obes Surg 2019 05;29(5):1462-1469

Université Côte d'Azur, Nice, France.

Background: Recent evidence has indicated an increased risk of Barrett's esophagus (BE) in the long term after sleeve gastrectomy (SG).

Aim: The aim of the study is to investigate the spectrum of gastroesophageal reflux disease (GERD) symptoms as well as the prevalence of BE, at minimum 5 years after SG in patients who underwent SG in different bariatric centers of two countries: France and Italy.

Patients And Methods: Five high volume outpatient centers dedicated to bariatric surgery that routinely perform upper GI endoscopy before any bariatric procedures were invited to participate in the study. Read More

Chest 2018 12;154(6):e181-e185

Department of Medicine, The University of Texas Southwestern Medical Center, Dallas, TX. Electronic address:

Case Presentation: A 57-year-old man was admitted for 1 month of accelerating hemoptysis and hematemesis. Two weeks earlier, he first presented with fevers and hemoptysis of 2 weeks' duration and was diagnosed with community-acquired pneumonia treated with 5 days of ceftriaxone and azithromycin. He improved and was discharged, but his hemoptysis recurred 1 day after discharge and progressed over 9 days, leading to the present admission. Read More

Can J Hosp Pharm 2018 Sep-Oct;71(5):295-301. Epub 2018 Oct 31.

, BSc(Pharm), PharmD, is with Lower Mainland Pharmacy Services, Surrey British Columbia, and the Therapeutics Initiative (The University of British Columbia), Vancouver, British Columbia.

Background: The use of proton pump inhibitors (PPIs) may cause significant harm to patients in the residential care setting, as these patients are often frail with multiple morbidities. The extent of non-evidence-based use of PPIs in residential care sites of the Fraser Health Authority in British Columbia is unknown.

Objective: To determine the proportion of non-evidence-based use of PPI therapy for residential care patients of the Fraser Health Authority. Read More

J Natl Med Assoc 2019 Apr 23;111(2):198-201. Epub 2018 Oct 23.

Division of Gastroenterology, University of Florida/Jacksonville, Jacksonville, FL, USA; Division of Gastroenterology and Hepatology, Augusta University-Medical College of Georgia, Augusta, GA. Electronic address:

Background And Study Aims: Barrett's Esophagus (BE) is a well-recognized pre-malignant condition. Previous data indicate histologically confirmed BE frequency varies by ethnicity in the United States. However, clinical factor assessment to explain this has only occurred in a veteran population to date. Read More

Surg Today 2019 Jan 25;49(1):27-31. Epub 2018 Aug 25.

Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 8795593, Japan.

Purposes: The choice between performing routine and selective upper gastrointestinal endoscopy (UGE) before bariatric surgery remains controversial. This study aimed to evaluate the clinical significance of UGE before laparoscopic bariatric procedures.

Methods: We enrolled 155 obese Japanese patients who underwent laparoscopic bariatric procedures at our institute and evaluated their endoscopic findings, such as reflux esophagitis (RE), hiatal hernia (HH), Barrett's esophagus, gastritis, duodenitis, gastroduodenal ulcer, gastric cancer, and polyps. Read More

World J Pediatr 2018 08 10;14(4):330-334. Epub 2018 Jul 10.

Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster NHS Fdn Trust, Imperial College London, London, UK.

Background: This study systematically reviewed etiology, prevalence, treatment and outcome of Barrett's esophagus (BE) in the pediatric population.

Methods: PubMed was searched for terms "Barrett's esophagus" and "children". End points were age of patients, etiology, association with other syndromes, treatment, incidence of carcinoma and outcome. Read More

Dig Dis Sci 2018 08;63(8):2155-2162

Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer, 1515 Holcombe Boulevard Unit 1466, Houston, TX, 77030, USA.

Barrett's esophagus is common in Western countries, but progression to esophageal adenocarcinoma is uncommon. Chemoprevention therefore needs to consider whether benefits outweigh risks given an otherwise healthy population. This will depend on the particular population at risk and the relative safety of a potential preventive agent. Read More

Gastroenterol Hepatol (N Y) 2018 Mar;14(3):169-175

Dr Khan is a third year gastroenterology fellow and Dr Howden is the Hyman Professor of Medicine and Chief of the Division of Gastroenterology at the University of Tennessee Health Science Center in Memphis, Tennessee.

Proton pump inhibitors (PPIs) have been in use since the early 1990s and play a crucial role in the management of a number of conditions affecting the upper gastrointestinal tract, including gastroesophageal reflux disease, Barrett esophagus, eosinophilic esophagitis, and dyspepsia. PPIs also play an important role in the treatment of infection and in the prevention of upper gastrointestinal tract ulcers and bleeding among patients taking antiplatelet therapy and/or nonsteroidal anti-inflammatory drugs. Despite recent concerns regarding the long-term safety of PPIs, their risk-benefit profiles strongly favor their appropriate use in patients who have genuine indications for them. Read More

J Fam Pract 2018 May;67(5):302-304

Mercy Health Saint Mary's, Grand Rapids, Michigan, USA.

40-year-old man was referred to the emergency department (ED) with critical anemia after routine blood work at an outside clinic showed a hemoglobin level of 3.5 g/dL. On presentation, he reported symptoms of fatigue, shortness of breath, bilateral leg swelling, dizziness (characterized as light-headedness), and frequent heartburn. Read More

Gastroenterology 2018 04 8;154(5):1209-1214. Epub 2018 Mar 8.

Division of Gastroenterology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address:

World J Gastroenterol 2017 Sep;23(33):6077-6087

Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA 15224, United States.

Aim: To efficiently replicate the biology and pathogenesis of human esophageal adenocarcinoma (EAC) using the modified Levrat model of end-to-side esophagojejunostomy.

Methods: End-to-side esophagojejunostomy was performed on rats to induce gastroduodenoesophageal reflux to develop EAC. Animals were randomly selected and serially euthanized at 10 (n = 6), 17 (n = 8), 24 (n = 9), 31 (n = 6), 38 (n = 6), and 40 (n = 6) wk postoperatively. Read More

Pol Przegl Chir 2017 Aug;89(4):29-32

Department of Surgery and Endoscopy Faculty of postgraduate medical education Lviv National Medical University.

The aim of the study was to evaluate the effectiveness of a diagnostic and therapeutic algorithm for gastroesophageal reflux disease complicated by Barrett's esophagus in 46 patients.

Materials And Methods: A diagnostic and therapeutic algorithm for complicated GERD was developed. To describe the changes in the esophagus with reflux esophagitis, the Los Angeles classification was used. Read More

Gastroenterology 2017 03;152(4):706-715

Divison of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Background & Aims: The purpose of this review is to evaluate the risks associated with long-term use of proton pump inhibitors (PPIs), focusing on long-term use of PPIs for three common indications: gastroesophageal reflux disease (GERD), Barrett's esophagus (BE), and non-steroidal anti-inflammatory drug (NSAID) bleeding prophylaxis.

Methods: The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed, EMbase, and the Cochrane library (through July 2016). To identify relevant ongoing trials, we queried clinicaltrials. Read More

World J Gastroenterol 2017 Jan;23(2):318-327

Masahiro Sakaguchi, Department of Gastroenterology, Moriguchi Keijinkai Hospital, Osaka 570-0021, Japan.

Aim: To assess the clinical characteristics of patients with complicated erosive esophagitis (EE) and their associated factors.

Methods: This prospective, cross-sectional study included patients diagnosed with EE by upper gastrointestinal endoscopy between October 2014 and March 2015 at 106 Japanese hospitals. Data on medical history, general condition, gastrointestinal symptoms, lifestyle habits, comorbidities, and endoscopic findings were collected using a standard form to create a dedicated database. Read More

Free Radic Biol Med 2017 03 3;104:75-103. Epub 2017 Jan 3.

Department of Physiology, Faculty of Pharmacy, University of Valencia, Burjasot, 46100 Valencia, Spain. Electronic address:

Redox signaling regulates physiological self-renewal, proliferation, migration and differentiation in gastrointestinal epithelium by modulating Wnt/β-catenin and Notch signaling pathways mainly through NADPH oxidases (NOXs). In the intestine, intracellular and extracellular thiol redox status modulates the proliferative potential of epithelial cells. Furthermore, commensal bacteria contribute to intestine epithelial homeostasis through NOX1- and dual oxidase 2-derived reactive oxygen species (ROS). Read More

Nat Rev Gastroenterol Hepatol 2017 04 5;14(4):230-240. Epub 2017 Jan 5.

Leeds Gastroenterology Institute, Level 4, Bexley Wing, St James's University Hospital, Beckett Street Leeds, LS9 7TF, UK.

Helicobacter pylori is an important human pathogen, associated with a substantial burden from both malignant and non-malignant diseases. The bacterium is classed as a human carcinogen, being strongly linked with gastric cancer, the third most common cause of cancer death worldwide and is also associated with common conditions such as dyspepsia and peptic ulcer. Eradication of H. Read More

Br J Cancer 2016 Nov 25;115(11):1383-1390. Epub 2016 Oct 25.

Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD 20850, USA.

Background: The absolute risk of oesophageal adenocarcinoma (EA) among individuals with Barrett's oesophagus (BE) is low and a majority of EA cases are diagnosed among individuals with no prior BE diagnosis. To ensure that insights from EA case-control studies are transferable to clinical management of BE populations, we conducted a case-case study to compare the clinical presentation, medical history and survival of EA cases with and without a prior BE diagnosis in the Surveillance, Epidemiology and End Results Medicare database.

Methods: Eligible EA cases were diagnosed at age ⩾68 years during 1994-2009. Read More

Ann Surg 2018 Jan;267(1):99-104

Esophageal and Digestive Tract Surgical Unit, Regional Centre for Oesophageal Disease, Veneto Institute of Oncology IOV IRCCS, Padova, Italy.

Objective: The aim of this study was to investigate trends in patients' characteristics and comorbidities in esophageal cancer (EC) patients.

Background: Identifying changing pattern is essential to understand and predict further changes and to plan surgical procedures and resource allocation.

Methods: Trends in patients' characteristics and comorbidities were evaluated in 4440 EC patients at the Center for Esophageal Diseases in Padova, Italy, during 1980 to 2011. Read More